ISSUE OF CHILDREN UNDERNUTRITION IN INDIA

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28 Dec ISSUE OF CHILDREN UNDERNUTRITION IN INDIA

Posted at 28 Dec 2023 in Current Affairs by
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UPSC MAINS SYLLABUS GS2: Issues relating to Poverty and Hunger

WHY IN NEWS?

High levels of child undernutrition have been a persistent problem in India since Independence. Malnutrition is the condition that develops when the body is deprived of vitamins, minerals and other nutrients it needs to maintain healthy tissues and organut function: 

  1. Determinants of undernutrition are multiple such as food intake, dietary diversity, health, sanitation, women’s status & poverty. 
  2. The most common measures of Childhood undernutrition are based on height forage i.e; Stunting or Chronic undernutrition and low weight for height i.e; Wasting or acute undernutrition.

ISSUE OF CHILD UNDERNUTRITION IN INDIA: 

  1. As per Global Hunger Index (GHI) 2023 published by Concern Worldwide of Ireland and Welthungerhilfe (a German non-profit organization): 
    1. India ranks 111th out of 125 countries (further slipped below 4 positions since 2022) below Sri Lanka (60), Nepal (69), Bangladesh (81) & Pakistan (102). 
    2. As per the Index, India has the highest Child wasting rate (18%) in the world. 
    3. The Hunger Index measures countries’ performance on 4 component indicators – 
      1. CHILD STUNTING: the share of children under the age of 5 who have low height for their age: 35.5 % 
      2. CHILD WASTING: the share of children under the age of 5 who have low weight for their height: 18.7 %
      3. CHILD MORTALITY: the mortality rate of children under the age of 5: 4%
      4. UNDERNOURISHMENT: the share of the population whose caloric intake is insufficient. 
  2. As per National Family Health Survey (NFHS-5) Report: 
    1. Stunting has reduced from 38.4% to 35.5%, wasting from 21.0% to 19.3% and underweight prevalence is down from 35.8% to 32.1%.
    2. Women (15-49 years) whose BMI (Body Mass Index) is below normal has reduced from 22.9% in NFHS-4 to 18.7% in NFHS-5.

ISSUES RELATED TO METHODOLOGY OF ASSESSMENT: 

As India envisages to become an Upper Income country by 2047 (Amrit Kaal), monitoring undernutrition among Children who will form the backbone of India’s demographic dividend (15-49 years) in future is imperative for efficient data-based policymaking. 

  1. India, like most other countries, uses the globally accepted World Health Organization (WHO) Growth Standards to measure malnutrition. 
  2. However, there is an emergent debate on a number of issues related to the use of these growth standards in India, some of which are discussed below.
  3. The WHO standards are based on a Multicentre Growth Reference Study (MGRS) that was conducted in 6 countries between 1997-2003 including Brazil, Ghana, India, Norway, Oman and the United States. 
  4. The purpose was to determine the pattern of growth from birth to 5 years of children who did not face any known deficiencies in their environments. 
  5. The MGRS took a prescriptive approach, with the specific aim of setting growth ‘standards’ (how children ought to grow, provided they have a healthy environment) and not growth ‘references’ (how children of the reference group grow).
  6. The sample for India in the MGRS was drawn from a set of privileged households living in South Delhi, of children who met all the eligibility criteria for the study including having ‘favorable’ growth environment, being breast­fed and having nonsmoking mothers. 

 

Some researchers who have analyzed data from other surveys for India suggest that these standards overestimate undernutrition: 

  1. For instance, even among children in households of the highest quintile in National Family Health Survey NFHS-­5 (2019­-21) only 12.7% meet requirements of a ‘minimum acceptable diet’ as defined by WHO.
  2. Difference in genetic growth potential of Indians with respect to other Country and the influence of maternal heights on child growth.
  3. There are also regional imbalances, for example states like Odisha, Chhattisgarh, Tamil Nadu and Kerala are achieving much faster reductions in Undernutrition than other states.
  4. The Ministry of Women & Child Development has recently rejected the findings of Global Hunger Index (GHI) stating: “Proportion of Undernourished population indicator is based on Opinion Poll conducted on a small sample size of 3000 people in a country of 1.3 Billion people.” 
  5. According to the ministry, since April 2023, the number of measurement data for children under the age of five that have been uploaded to the Poshan Tracker has steadily climbed, rising from 6.34 crore in April 2023 to 7.24 crore in September 2023.
  6. In light of these discussions, the Indian Council of Medical Research (ICMR) has constituted a committee to revise the growth references for India & recommended a detailed rigorous study to be conducted across the country to examine child growth with the purpose of devising national growth charts.

STEPS TAKEN BY THE GOVERNMENT TO CURB UNDERNUTRITION: 

  1. POSHAN Abhiyaan: The government of India has launched the National Nutrition Mission (NNM) or POSHAN Abhiyaan to ensure a “Malnutrition Free India” by 2024. 
  2. Anemia Mukt Bharat Abhiyan: Launched in 2018, the mission aims at accelerating the annual rate of decline of anemia from one to three percentage points.
  3. Mid-day Meal (MDM) scheme: It aims to improve nutritional levels among school children which also has a direct and positive impact on enrolment, retention and attendance in schools.
  4. The National Food Security Act (NFSA), 2013: It aims to ensure food and nutrition security for the most vulnerables through its associated schemes and programmes, making access to food a legal right.
  5. Pradhan Mantri Matru Vandana Yojana (PMMVY): Rs.6,000 is transferred directly to the bank accounts of pregnant women for availing better facilities for their delivery.
  6. Integrated Child Development Services (ICDS) Scheme: It was launched in 1975 and the scheme aims at providing food, preschool education, primary healthcare, immunization, health check-up and referral services to children under 6 years of age and their mothers.
  7. Eat Right India movement by Food Safety and Security Authority of India – FSSAI.

INNOVATIVE WAY FORWARD: 

  1. Increase Financial Commitments: There is a greater need to increase investment in women and children’s health and nutrition to ensure their sustainable development and improved quality of life.
  2. Outcome-oriented Approach: India must adopt an outcome-oriented approach on nutrition programmes. There has to be direct engagement with nutritionally vulnerable groups (this includes the elderly, pregnant women, those with special needs and young children), and contribute toward ensuring last-mile delivery of key nutrition services and interventions.
  3. Basic Education and General Awareness: Various studies highlight a strong link between mothers’ education and improved access and compliance with nutrition interventions among children.
  4. Programmes’ Monitoring and Evaluation: There should be a process to monitor and evaluate programmes and address systemic and on the ground challenges.

 

There is a need to deliberate over effective policy decisions, monitor the implementation of schemes, and review nutritional status across States. 

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PRELIMS 2024 PRACTISE QUESTION: 

Q1: Consider the following statements regarding Global Hunger Index (GHI) 2023: 

  1. India ranks 107th out of 124 countries improving its place by 4 position
  2. As per the Index, India has the highest child wasting rate in the world
  3. The proportion of “Wasted” children is less than the proportion of “Stunted” children
  4. India’s ranks better than other South Asian countries such as Nepal, Bangladesh & Pakistan

Which of the above statements is correct? 

A. 2 and 3 

B. 1 and 3

C. 2 and 4 

D. 1 and 4 

ANSWER: A

 

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